Lucy’s knot-buster massage sessions focus on the relief of crunchy or tender ‘knots’ in the muscle tissue (usually around the shoulders). The following article explains a little bit more about what muscle knots are, how they form, and how to get the most from your knot-buster massage session.

What are Muscle Knots?

Muscle knots are bumps of hard, sensitive tissue located in tense muscles. They may be quite small and gritty and easily broken down, but some of them are really huge and take quite a lot of work to release the tension in the surrounding muscle tissue. Biopsies of muscle knots have shown abnormal protein deposits which may account for the crunchy, grittiness present in some muscle knots.

The technical term for muscle knots is ‘myofascial trigger points’. You may have heard of ‘trigger point therapy’, or ‘myofascial release’. These techniques involve applying steady, sustained pressure on the knot. It can sometimes be quite painful, and sometimes it even causes pain in another part of the body altogether. This is called referred pain and believe it or not, untreated muscle knots in the back can cause headaches, toothache, sore throats, ear ache, sinusitis and dizziness. It is normal to experience pain during this type of treatment but it should never go beyond what you might call ‘good pain’ – that strange sensation that makes the pain seem almost pleasant – when you know its doing you good. Beyond that level, this is an indicator that the surrounding muscle tissue is still too tense to really release the knot. Even if you ‘grin and bear it’ in the name of getting rid of knot, the chances are it will come straight back because fundamentally you still have a tight muscle. In fact, stoically coping with excessive pain is the worst thing you can do, when what you should be trying to achieve is deep relaxation.

What causes knots?

Knots occur when a particular muscle gets so tense that it restricts its own circulation of blood and tissue fluid. This causes a build up of waste products (e.g. urea, excess proteins) that aggravate the nerve endings and cause more muscle clenching – a vicious cycle. Knots or ‘trigger points’ can either be active or latent. Active trigger points are those which cause discomfort. Latent trigger points wait silently in the muscle for a future stress to activate them. Often when you have a massage, you discover knots you never even knew you had – these are latent trigger points waiting for their moment!

So what makes these muscles so tight in the first place? Some people would argue that overuse makes muscles permanently ‘on’ and makes them tight, others state the opposite, that under-use of muscles causes them to get stiff and inflexible. My opinion is that both are most likely to be correct – both overuse and stagnation of muscles can cause them to seize up. The unfortunate truth is that most people develop a few knots through general wear and tear, but there are certain circumstances that are particularly likely to cause knots:

Injuries: muscles often go into spasm to protect an injury, which is great in the short term for helping the injury to heal, but if the muscle never relaxes again can cause trigger points to develop in the long term. This is why massage therapy is ruled out within 48hours of an injury, but strongly recommended in the subsequent recovery and rehabilitation period.

Computers: repetitive movements and awkward positions: Everyone is probably tired of the lectures about computers, but think about how long you can spend at a time with your arm hovering in mid air over a mouse – that is how long the muscles in your shoulder are stuck in a contraction holding it there!

Postural Dysfunction: Sounds serious but this just refers to when your body is not in perfect alignment. For instance, if you hold your head too far in front of you, the muscles in the back of your neck will probably be chronically overstimulated and irritated by the effort of holding your head up. Postural misalignments tend to be the result of long-held bad habits and can take quite some effort to correct – but it is not impossible. A simple postural analysis only takes 10-15mins and can be quite revealing. A massage can then be planned to help relax and /or strengthen muscles to assist in any realignment that is necessary. This usually needs to be done in conjunction with corrective exercises.

Emotional stress: when we are under a lot of pressure or stress from emotional issues or work issues, we often become very guarded and defensive, causing the body to become rigid and tense. Have you ever been getting frustrated or worried about something only to discover your shoulders are around your ears and you haven’t remembered to breathe for a few seconds? In a moment you remind yourself to relax, let go, take a deep breath and drop your shoulders. However, sometimes we can go for days or weeks on end without ever getting to that moment. Prolonged emotional stress and strain can cause severe tension all over the body. I read a book recently about someone who felt they couldn’t relax, because if they did, the whole world would crumple around them. We have a survival instinct to ‘hold ourselves together’ during times of crisis, but it can do terrible things for your muscle tissues if left too long!

Other causes of knots I came across when researching the matter were overexerting yourself thereby discovering ‘muscles you never knew you had’, and exposure to cold drafts. It might sound like an old wives’ tale, but it seems that getting cold really can get you in a bad way as all your muscles tense up in the fight to keep you warm inside. Wrap up warm in winter!

Will they go away?

The good news is ‘yes’, knots can be treated and can eventually go away. However, trigger points come back for the same reasons that they formed in the first place, unless the causes are eliminated. Massage therapy is one of the most effective treatments for muscle knots but that alone will never remove your muscle knots for good. To really keep them under control I’m afraid you have to do your homework – gentle stretching – and think about what is causing those knots in the first place.

How can muscle knots be treated?

Massage is not the only way to treat muscle knots. Acupuncture is recommended by many people or you can have a local anaesthetic injected into a knot (does not sound like fun!). Gentle stretching and exercise will help keep the muscle warm and flexible and also causes you to start becoming aware of the points yourself. The power of the mind should not be underestimated, and often conscious relaxation of a particular muscle group can have far more effect than minutes of uncomfortable rubbing and pressing. Massage is one of the most popular ways of removing muscle knots but it needs to be a two-way process where the client is able to say when the pain gets too much. A painful massage that makes you more tense may break down some knots in the short term is not, in my opinion, going to help in the long term.

How to get the most from your massage treatment:

To maximise the benefits of a massage that works on deep muscles and trigger points there are a few things you can bear in mind:

Allow time to relax before and after the treatment. If possible, have a warm shower or bath beforehand to really warm up the muscles and let them relax. Afterwards, go gently on your way… move slowly, stay warm and avoid over stimulating your muscles.

Avoid strong stretching or intense exercise for a couple of days after the treatment. Muscles containing trigger points like to be stretched, but only gently. I’m currently working on some stretching routines specifically for the common trigger points in the shoulders so more on that soon.

It is usually recommended to drink extra water afterwards to assist the body in detoxifying after the massage. One source I consulted seemed to think the evidence for this is ‘dubious’, but it makes sense to me! At the end of the day, the key to all of this is to…

Really excellent. I have numerous muscle knots, I had fibromyalgia for 8 years, but I am now fantastic. I have no emotional stress in my life , love my job and am very happy. So how can I have so many muscle knots tks jane

Thanks for your comment Jane – great that you now feel so fantastic! What I tell my clients is that the tension and stress in our bodies is accumulated over many years – we have to be patient and kind with ourselves in allowing the body to heal. Those muscle knots of yours may never go away, but you can kindly and patiently allow them to relax and let go. Slowly but surely they will.

I agree ^^
This is really informative and honest and helpful. Thank you! Thanks especially or mentioning that emotional stress can be a factor. I often don’t breathe since I worry a lot and that adds so much tension to my neck and thus my back and jaw.

I look forward to the shoulder exercises the author mentioned they were working on..